1. ECC I NITIATIVE : N EXT S TEPS Bonnie Bruerd, DrPH

2. ECC Initiative: Next Steps Review of ECC Components: Collaborative and Comprehensive Best Practices: pregnancy, 0-2, 3-5 Dental Access for 0-5 year olds Caries Stabilization Data Collection: BSS Survey “Any change, even a change for the better, is always accompanied by drawbacks and discomforts.”

3. Do Your Homework! “By failing to plan, you are planning to fail.” Review the ECC Packet Review the ECC Initiative website Take the online courses if you will be recommending them to others. Read supporting articles if you have any questions or concerns.

4. Get the Facts “ Knowledge is a process of piling up facts; wisdom lies in their simplification.” Gather Local Data Number of live births a year Number of exams for 0-2 and 3-5 year old children Number of fluoride varnish treatments for 0-2 and 3-5 year olds Number of sealants for 0-2 and 3-5 year olds Number of ITRs (2940) for 0-2 and 3-5 year olds

5. A SK S OME Q UESTIONS Where do families take babies in your community? (WIC, Well-Child) Do you have daycare centers for infants and toddlers? Do you have a HS or EHS program? How much money does your program spend on referring children who have ECC? How many children each year receive their dental treatment in the OR?

6. B EST P RACTICES : N EXT S TEPS Incorporate BP every step of the way! Educate your medical and community partners about BP and the key oral health messages. Stress the importance of promoting the key oral health messages in your community. Brainstorm ways to promote the key oral health messages through local media, mailings, and so on.

7. E FFECTIVE H EALTH E DUCATION : W HAT W ORKS ? Small steps Positive reinforcement Interactive and individualized strategies Repeated, consistent messages from dental staff and community partners.

8. BEST PRACTICES: THE EXTRA STEP Learn about chemotherapeutics such as xylitol, chlorhexidine, iodine, etc. Work with your DSC to apply for grants to support pilot projects. Provide free fluoride toothpaste. Apply for HP/DP awards to support your local efforts.

9. D ENTAL A CCESS FOR 0-5 YEAR OLDS : N EXT S TEPS Plan a meeting with key medical and community partners in your community. Make a chart of who does what for each age group. Teach medical and community partners how to apply fluoride varnish and provide key oral health messages.

10. D ENTAL A CCESS : M ORE S TEPS Provide open access for 0-2 year olds for fluoride varnish and family education. Use birthday cards or other mailing programs to increase access. Go to daycare/HS centers to provide exams and fluoride varnish. Track your progress through RPMS data.

11. DENTAL ACCESS: THE EXTRA STEP “Imagination is more important than knowledge. For while knowledge defines all we currently know and understand, imagination points to all we might yet discover and create.” Consider a 0-5 Case Manager Model: Track all 0-3 year olds Build relationships with families. Apply fluoride varnish and key oral health messages 3-4 times a year. Provide sealants and ITR for caries stabilization. Track any needed referrals.

12. C ARIES S TABILIZATION : N EXT S TEPS Take the online course. Incorporate ITR into your dental program. Keep in mind that your attitude will set the stage for adoption of ITR.

13. ITR: T IPS FROM THE F IELD Variations on the knee to knee technique Distraction is key. ITRs must be recharged daily with topical fluoride. Barbie and Spiderman fillings Building this relationship early on makes for a more cooperative 3-4 year old dental patient.

14. ITR: TIPS FROM THE FIELD: Keep Your Cool! If a prostodontist can do it, YOU can do it too! Dr. Winkle keeps his cool.

15. ITR: T HE E XTRA S TEP Track the money you spend referring 0-5 year olds and make it a goal to reduce the number of referrals and the dollar amount of those referrals. Head Start: Provide exams, FV, sealants, and ITR early on in the school year. Refer as needed. Provide more complex treatment as a second step.

16. BSS D ATA C OLLECTION : T HE N EXT S TEPS Learn all you can about the BSS survey methods and begin marketing it in your local community. But, don’t begin collecting data yet! There will be new forms and training developed later this year. DSCs and ADOs will orchestrate data collection. Stay tuned!

17. ECC Initiative and GPRA “Not everything that can be counted counts, and not everything that counts can be counted.” Einstein Access Topical Fluoride Sealants

18. MAKE A PLAN! Review the ECC Initiative packet and webpage with your entire staff. Decide which components you want to focus on and set up meetings with key Community Partners. Make a training plan for both dental and community partners. Identify whether you will need additional resources. Make an evaluation plan!

19. Together, we CAN make a difference!